Abstract

Where out-of-pocket payment (OOP) serves as the major means of financing health care, the cost of health care might differentially influence health seeking behavior of households of different socio-economic status (SES) groups. This study examined the variations in health care seeking and incidence and level of OOP across households of various SES groups.The study which was carried out in south-east Nigeria found that the poorest households had the least incidence of spending on health care. The most common reason among the poorest households for not spending on health care when they should have was the cost of health services while for the richest households, it was because the illness was not considered serious enough. Households in the richest quintile representing 19.7% of the entire population accounted for 50.6% of the total expenditure on health while those in the second quintile and the poorest quintile accounted for 9.9% and 6.4% of total health care expenditure respectively. As such there is a wide gap between what poor and rich households spend on health and with no financial protection mechanism, poor households could be forgoing much needed health care. Policy makers need to be persuaded that a shift away from out-of-pocket payment for health care which is inequitable and inefficient is necessary and requires urgent attention.